Healthcare Provider Details

I. General information

NPI: 1306516877
Provider Name (Legal Business Name): SOPHIE KUHN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2021
Last Update Date: 09/16/2021
Certification Date: 09/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 BROADWAY
NEW YORK NY
10004-1010
US

IV. Provider business mailing address

420 E 138TH ST APT 3B
BRONX NY
10454-3239
US

V. Phone/Fax

Practice location:
  • Phone: 646-543-4774
  • Fax:
Mailing address:
  • Phone: 504-717-1132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number113991
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: